THENATIONALCENTERFOREMOTIONALWELLNESS

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COPING WITH A MASS CASUALTY INCIDENT

23 Things We Can Do to Foster Emotional Wellness

During a mass casualty incident (MCI), the primary goal must be the stabilization of injury and the preservation of life. Our physical and safety needs are always the priority.

As we have learned, physical trauma can destroy many lives. However, we have also learned that a “hidden trauma,” traumatic stress, will ultimately destroy many more. Traumatic stress refers to our feelings, thoughts, actions, and our physical and spiritual reactions when we are exposed to, or even witness, events that overwhelm our ability to cope.

Following is a list of twenty-three things we can do to foster Emotional Wellness during and in the aftermath of, an MCI:

1. Take immediate action to ensure your physical safety and the safety of others. If possible, remove yourself from the event/scene in order to avoid traumatic exposure.

3. Find a safe place that offers shelter, water, food, and sanitation.

4. Become aware of how the event is affecting you (i.e., your feelings, thoughts, actions and your physical and spiritual reactions).

5. Know that your reactions are normal responses to an abnormal event. You are not “losing it” or

“going crazy.” It’s okay not to be okay, right now.

6. Speak with your physician or healthcare provider and make him/her aware of what has happened to you.

7. Be aware of how you’re holding-up when there are children around you. Children will take their cues from the adults around them.

8. Try to obtain information. Knowing the facts about what has happened may help to give you back a sense of control, at a time when you're feeling a loss of control.

9. If possible, surround yourself with family and loved ones. Realize that the event is likely affecting them, too.

10. Tell your story and allow yourself to feel. Your feelings are not right or wrong ... they just are. People who expose themselves to their thoughts and feelings, early on, tend to fare better than those who don't.

11. You may experience a desire to withdraw and isolate, causing a strain on significant others. Resist the urge to shut down and retreat into your own world; avoid avoidance.

12. Traumatic stress may compromise your ability to think clearly. If you find it difficult to concentrate when someone is speaking to you, focus on the specific words they are saying and work to actively listen. Slow down the conversation and try repeating what you have just heard.

13. Don’t make important decisions when you’re feeling overwhelmed. Allow trusted family members or friends to assist you with necessary decision-making.

14. Speak with people who who are empathic and compassionate listeners, rather than people who who have all the answers. No one has the right to tell you how to feel!

15. If stress is causing you to react physically, use controlled breathing techniques to stabilize yourself. Take a slow deep breath by inhaling through your nose, hold your breath for five seconds and then exhale through your mouth. Upon exhalation, think the words “relax,”

“let go,” or “I’m handling this.” Repeat this process several times.

16. Know that sleep difficulties and repetitive thinking are normal reactions. Don’t fight sleep difficulties. Try the following: eliminate caffeine for four hours prior to your bedtime, create the best sleep environment you can, consider taking a few moments before turning out the lights to write down your thoughts, thus “emptying” your mind. Speak with your healthcare provider about addressing this common "target symptoms."

18. If you are able, physical exercise or any movement (e.g., walking) may help to dissipate the stress energy that has been generated by your experience.

19. Create a journal. Writing about your experience may help to expose yourself to painful thoughts and feelings and, ultimately, enable you to assimilate your experience.

20. If you find that your experience is too powerful, allow yourself the advantage of professional and/or spiritual guidance, support and education.

21. Limit watching and listening to the news on television and online. Many people experience very real traumatic stress reactions by repetitively watching the news.

22. Try to maintain your schedule. Traumatic events will disrupt the sense of normalcy. We are all creatures of habit. By maintaining our routines, we can maintain a sense of control at a time when circumstances may lead us to feel a loss of control.

23. In the same way we become "experts" on our physical conditions, learn about how you can harness your painful emotional energy, and use it in goal-directed problem-solving ways.